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Posterior compression test: a provocative test for detecting posterior labral tears

Rhee SM, Youn SM, Lee JU, Kim CH, Kim SY, Ham HJ, Rhee YG

Indian Journal of Orthopaedics 2024 Jan;58(1):48-55

primary study

PURPOSE: The purpose is to assess the diagnostic accuracy of a provocative test coined as the 'posterior compression test' (PCT) in those with the suspected posterior labral tear or lesion. METHODS: A total of 515 arthroscopic labral repairs were identified between April 2013 and September 2020. Excluding those with concomitant shoulder pathologies, and only including those with pre-operative documentation of the PCT and/or the Jerk test, 191 patients were included. For the purposes of the analyses, the patients were divided into 'non-posterior' labral tear group which included the anterior labral tears and/or the superior labral anterior-to-posterior (SLAP) tears, versus 'any posterior' labral tear group which included the isolated posterior labral tears, the SLAP tears with posterior extension and the pan-labral tears. RESULTS: When the PCT was performed for the isolated posterior labral tears, the sensitivity was 92.6% with the specificity of 86.5%. The positive predictive value and negative predictive value were 71.4 and 97%, respectively. The Jerk test's sensitivity was 77.8% but when the two tests were combined, the sensitivity increased up to 96.3%. The combined sensitivity with the Jerk test was still up to 94.6% with the AUC (area under curve)/ROC (receiver operator characteristic) at 0.855. Low 'false-positive' rate with the PCT was observed when the test was performed for the 'non-posterior' labral group, with the sensitivity of 13.5%. CONCLUSIONS: The posterior compression test correlated well with the arthroscopic diagnoses in a subset of patients with suspected posterior labral pathology, possibly by means of direct stimulation. LEVEL OF EVIDENCE: III; Diagnostic Study.

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